Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDOKNOT VICRYL

Facility

$124.00

Hospital Charge Code	270335233
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

ENDOKNOT VICRYL

Facility

$124.00

Hospital Charge Code	270335233
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

ENDO LEVEL 1 VISIT

Facility

$224.00

Service Code	HCPCS 99211
Hospital Charge Code	2300920
Hospital Revenue Code	510
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$85.12
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

ENDO LEVEL 1 VISIT

Facility

$224.00

Service Code	HCPCS 99211
Hospital Charge Code	2300920
Hospital Revenue Code	510
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.00
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$330.00
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$64.95
Max. Negotiated Rate	$64.95
Rate for Payer: Qualcare PPO/HMO/WC	$64.95

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$216.50
Rate for Payer: Aetna Commercial	$164.54
Rate for Payer: Aetna Medicare Advantage	$129.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.42
Rate for Payer: Cigna Commercial	$216.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.90
Rate for Payer: Oxford Commercial	$86.60
Rate for Payer: Qualcare PPO/HMO/WC	$64.95
Rate for Payer: UnitedHealthcare Commercial	$86.60
Rate for Payer: UnitedHealthcare Community & State	$10.44
Rate for Payer: Wellpoint Medicaid Managed Care	$11.47

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$19.55
Max. Negotiated Rate	$405.50
Rate for Payer: Aetna Commercial	$308.18
Rate for Payer: Aetna Medicare Advantage	$243.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.81
Rate for Payer: Cigna Commercial	$405.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.30
Rate for Payer: Oxford Commercial	$162.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.65
Rate for Payer: UnitedHealthcare Commercial	$162.20
Rate for Payer: UnitedHealthcare Community & State	$19.55
Rate for Payer: Wellpoint Medicaid Managed Care	$21.49

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$121.65
Max. Negotiated Rate	$121.65
Rate for Payer: Qualcare PPO/HMO/WC	$121.65

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$73.95
Rate for Payer: Qualcare PPO/HMO/WC	$73.95

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$246.50
Rate for Payer: Aetna Commercial	$187.34
Rate for Payer: Aetna Medicare Advantage	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.72
Rate for Payer: Cigna Commercial	$246.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.90
Rate for Payer: Oxford Commercial	$98.60
Rate for Payer: Qualcare PPO/HMO/WC	$73.95
Rate for Payer: UnitedHealthcare Commercial	$98.60
Rate for Payer: UnitedHealthcare Community & State	$11.88
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$697.50
Rate for Payer: Oxford Commercial	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Commercial	$465.00
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$348.75
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$341.45
Rate for Payer: Aetna Commercial	$259.50
Rate for Payer: Aetna Medicare Advantage	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.14
Rate for Payer: Cigna Commercial	$341.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.87
Rate for Payer: Oxford Commercial	$136.58
Rate for Payer: Qualcare PPO/HMO/WC	$102.44
Rate for Payer: UnitedHealthcare Commercial	$136.58
Rate for Payer: UnitedHealthcare Community & State	$16.46
Rate for Payer: Wellpoint Medicaid Managed Care	$18.10

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$102.44
Max. Negotiated Rate	$102.44
Rate for Payer: Qualcare PPO/HMO/WC	$102.44

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.30
Rate for Payer: Oxford Commercial	$36.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$36.20
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$74.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.05
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$74.47
Rate for Payer: Wellpoint Medicaid Managed Care	$81.89

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$74.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.05
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$74.47
Rate for Payer: Wellpoint Medicaid Managed Care	$81.89

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$74.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.05
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$74.47
Rate for Payer: Wellpoint Medicaid Managed Care	$81.89

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$23.33
Max. Negotiated Rate	$23.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.33

Know your out-of-pocket cost for care.

All Charges